9 minute read
FEATURED STORIES
by WONCA
W O N C A W P & S I G S N E W S
ISN - KDIGO - WONCA JOINT WEBINAR
WONCA WP & SIGS NEWS
The session also featured presentations by Dr Vivekanand Jha, Past-President of the International Society of Nephrology (ISN) and Dr Magdalena Madero, Chair of the ISN Latin AmericanRegionalBoard.
DR VIVEKANAND JHA
P A S T - P R E S I D E N T O F I S N
According to ISN, there are 850 million people living with kidney disease worldwide. “The number of Chronic kidney disease is highest in lowincome countries and lower, middle-income country, however, a consensus to treat it is needed”
ISN-KDIGO CKD EARLY IDENTIFICATION AND INTERVENTION TOOLKIT
Chronic kidney disease (CKD) causes substantial global morbidity and increases cardiovascular and all-cause mortality, so identifying and treating it at the earliest stages is a worldwide imperative. To this end, the ISN and KDIGO launched a series of tools for CKD early identification and intervention aimed at kidney health professionals, primary care physicians and nurses workinginprimarycaresettings. ThewebsiteincludesaseriesofresourcesforCKD earlyidentification,including: Quickguidesandinfographics Teachingtoolsforhealthteams Resourcesforpatients Conferencereportandarticles Webinarsandwebcasts
Discoverandaccessthesetools:
CKDEarlyIdentificationand InterventionToolkit
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WORLD HEALTH DAY 2022 Our Planet, Our Health
#HealthierTomorrow
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Every year on 7 April, we celebrate World Health Day, a date focused on raising awareness about the importance of health as a fundamental right, drawing attention to a specific health topic of concerntopeopleworldwide. This year, WHO focus global attention on the interconnectedness between the planet and our health. In the midst of a pandemic, a polluted planet, and increasing diseases like cancer, asthma and heart disease, WHO highlights urgent actions to keep humans and the planet healthy and foster a movement to create societies focusedonwell-being. According to WHO, more than 13 million deaths around the world each year are due to avoidable environmental causes. This includes the climate crisis which is the single biggest health threat facinghumanity. "The climate crisis is also a health crisis. Breaking these cycles of destruction for the planet and human health requires legislative action, corporate reform and individuals to be supported and incentivized to make healthy choices. " Through this year’s campaign: “Our planet, our health ” , WHO urge governments and the publicto share stories of steps they are taking to protect the planet and their health and prioritize well-beingsocieties.
image credit: WHO.ORG
image credit: WHO.ORG
image credit: WHO.ORG
FEATURED STORIES
The theme of World Health Day 2022 "Our Planet, Our Health" makes us aware of the importance of caring for our planet as an essential habit in caringforourownhealthandthecommunity. We, as family physicians, have a crucial role to play in sharing with our patients and the community the close relationship between personal health and the health of the planet. Proximity, longitudinality, and comprehensiveness are crucial values of family medicine in the care of citizens and are also essential values to improve the health of the planet. Our job is to explain and share the close connection between personal and planetary health. From our practice, we can raise awareness and promote caring behaviours for the planet. Small gesturescounteverydaytoachievethis. We are many family doctors worldwide, visiting many patients every day, and we participate in health promotion activities in the communities we serve. These are crucial opportunities to raise awareness about caring for the planet: start a conversation with our patients about the impact of our habits on planetary health; give concrete examples such as recycling materials, equipment and technology, consuming local food, reducing meat consumption, walking or cycling versus using the personal car, promoting public or collective transport, reducing the use of paper in consultations, reducing the use of medicines in pressurized containers, recycling medicines in pharmacies. All these efforts count to avoiding high concentrations of pharmaceuticals in the water we drink, our rivers, vegetables and fruit crops; reducingmicroplasticsinourseas;loweringthe pollutant particles in the air, preventing an increaseorworseningofrespiratoryproblems. The central question for reflection is are “producing” health if we are not looking for the environmentalconsequencesofouractions. In 2020, England’s National Health Service became the world’s first health service to commit to net-zero emissions. By this year’s World Health Day, there are now over 50 countries committed to being Sustainable Low Carbon Health Systems and18countrieswithnet-zerohealthcaretargets. Interventions to get the NHS to Net Zero range from improving energy efficiency in hospitals, to installing solar panels, to developing the world’s first hydrogen-electric ambulance, to working with its 80,000 suppliers to ensure they have carbon reduction plans with the NHS’s own targets. Primary care is leading the way in terms ofimplementingnetzerointerventions.
WONCA WP on Environment
WORLD HEALTH DAY 2022 ONE MINUTE FOR OUR PLANET
The Green Impact for Health Toolkit provides practical tips for general practices to reduce their environmental footprint across 13 different areas, with the opportunity to reach a Bronze, Silver, Gold or Carbon rating. Metered-dose inhalers contribute a substantial proportion of primary care emissions. The Greener Practice guide, How to reduce the carbon footprint of inhaler prescribing? A guide for healthcare professionals supports better patient management of asthma and COPD alongside patient-focussed prescribing to switch to dry powder inhalers where appropriate. General practices can also estimate their non-clinical emissions from energy, travel, IT, waste, business services and procurement, usingthiscalculatorfromSEESustainability. If every family doctor spends one minute communicating the close relationship between personal and planetary health, the action will multiply for the benefit of humanity and our planet. Start sharing messages about the health of the planetandourhealthwithyourpatientstoday! To get more ideas, you can join the online course about Planetary Health of the WONCA WP on Environment. We believe that evidence-based medicine and planetary health knowledge can promote a minutefortheplanetintheclinicalencounter.
FEATURED STORIES
DR MARÍA PILAR ASTIER PEÑA
WONCA EXCUTIVE MEMBER AT LARGE
Incollaborationwith:
WONCA WP on Environment
DR ÖZDEN GÖKDEMIR
CHAIR -WP ON ENVIRONMENT
DR ENRIQUE FACETO DE BARROS
DR MAYARA FLOSS
DR ALICE MCGUSHIN
Our Planet, Our Health
#HealthierTomorrow
JOIN THE THIS WP
F E A T U R E D S T O R I E S
RELATIONSHIP AND TRUST
PREREQUISITES OF THE MEDICAL CONSULTATION
FEATURED STORIES
Anna Stavdal’s article “From the President: On Family Doctors’ Vaccine Dilemmas” addresses the dilemma of what happens when a patient rejects the Covid vaccination despite the doctor’s science-based recommendation, and despite the resulting risk of serious consequences, not only for the patient’s health but also for the health of others. Anna Stavdal invites family doctors to reflect on howwecancopewithsuchdilemmas. With its far-reaching uncertainties Covid reveals and amplifies pre-existing problems on all, relational, medical, epidemiological and societal issues and the complex interactions between them on their micro, meso and macro levels –goingfarbeyondCovid. Dilemmas are subliminally present in each medical encounter and they affect both, the doctor and the patient. This is true because of the complexity, uncertainty and ambivalence. These three factors are at work in all the patient’s diseases / illnesses and healing processes. Dilemmas are also inherent to the scientific medical knowledge and therefore to all medical interventions from analysis to diagnosis, therapy and prevention. And let’s not forget, they are present in each interaction between doctor and patient and influence their relationship and trust. To be aware of this circumstance is crucial for eachmedicaldecision-makingprocess. This awareness allows the doctor to have a self critical attitude and to meet the patient on an equal footing - like two experts: the patient being the expert of their unique disease / illness, their psycho-socio-economical context, targets, values, beliefs,experiencesandresources. The doctor as an expert of medical knowledge, their professional experiences and, not to forget, personalconvictions. Authors Dr Bruno Kissling, family doctor, former Teaching Doctor Peter Ryser, specialist in Systemic Counselling, Teacher and Supervisor in Solution-Oriented Medicine
Dr. Bruno Kissling
F E A T U R E D S T O R I E S
This mutual respect leads to a sustainable relationship, to trust and to a feeling of safety. Relationship and trust are recognised as the foundation of any collaboration. A reliable collaboration finally leads to mutual understanding and the clarification of different views and interests. It leads to good solutions which are appropriate and acceptable for the patient and the doctor and to more satisfaction for both. This makes dilemmas easier to bear for both,doctorandpatient. We have been dealing with precisely all these issues around the highly sensitive interactive encounter of doctor and patient for over 30 years. Bruno as a family doctor and Peter as a specialist in systemic, solution-oriented counselling and as asupervisoroffamilydoctors. ogether we have summarized all our experiences in the book “Mastering the Medical Consultation” . Using practical examples, we discuss in seven steps, how the doctor can structure the consultationandhowtheycancommunicatewith the patient. We reflect on why these approaches are useful. We show, how the doctor can build up and maintain a creative relationship. How they can ask questions which lead to the required clinical answers plus have the potential to make the patient widen their perspective on their problem. We reflect on how, together, they can create a common reality out of the patient’s and doctor’s realities. How they can reveal, what the patient really wants from the encounter with the doctor. How they can negotiate a reliable cooperation for an open-ended shared decisionmaking process. How they can deal with each other when there is a disagreement. And finally, how they decide on the next steps of an ongoing therapeutic process and how they conclude a treatment. We also address how they can terminate their relationship when they cannot find a constructive level at all. We end with questions which help the doctor to reflect on the consultation on a medical but also interpersonal andintrapersonallevel. The book also contains chapters on topics which are part of all steps of the consultation, such as active listening, physical proximity and contact, ambivalence, discussing therapeutic options, dealingwitherrors… Unfortunately, all these basic communication skills and organizational competences are not or onlyinsufficientlytaughtatmostmedicalschools. Inourlongstandingcooperationwithexperienced doctors, we have learned that there is a real need for repeated reflection on their own professional attitude and for training of their communication skills. Preferably in supervised peer group meetings. The participants share positive and negativeclinicalexamplestheyexperienced.They discuss which interactions have been helpful and which have not. Beyond the medical topics they can also discuss their emotional experiences. As a further benefit these peer-group encounters help the participants to look after their own personal wellbeing. We all agree: We can only be good doctors, when wealsocareforourselves. ‣PrefacesbyIonaHeathandSusanne ‣RabadyFreeAssociationBooks,London,2021 ‣ Book Prize of the European Society for PatientCenteredHealthcareESPCH2020 ‣OriginalinGerman:«DieärztlicheKonsultation–systemisch-lösungsorientiert», Vandenhoeck & Ruprecht,2019
FEATURED STORIES
Dr. Bruno Kissling, family doctor, former Teaching Doctor
Peter Ryser, specialist in Systemic Counselling, Teacher and Supervisor in Solution-Oriented Medicine
